Can Cytoreductive Nephrectomy Improve Outcomes of Nivolumab Treatment in Patients with Metastatic Clear-Cell Renal Carcinoma?-Reference-Cited by-同舟云学术

Can Cytoreductive Nephrectomy Improve Outcomes of Nivolumab Treatment in Patients with Metastatic Clear-Cell Renal Carcinoma?

Published:2024-09-04 Issue:9 Volume:31 Page:5195-5205
ISSN:1718-7729
Container-title:Current Oncology
language:en
Short-container-title:Current Oncology

Author:

Ocak Birol¹^ORCID,Sahin Ahmet Bilgehan²,Ertürk Ismail³,Korkmaz Mustafa⁴,Erdem Dilek⁵,Cakıroglu Umut⁶,Karaca Mustafa⁷,Dirican Ahmet⁸,Olmez Omer Fatih⁹,Goktas Aydın Sabin⁹,Gökyer Ali¹⁰,Kücükarda Ahmet¹⁰,Gülmez Ahmet¹¹,Yumuk Perran Fulden¹²,Demircan Nazim Can¹²,Oyman Abdilkerim¹³,Sakalar Teoman¹⁴,Karatas Fatih¹⁵,Demir Hacer¹⁶,Yasin Ayse Irem¹⁷^ORCID,Deligonul Adem²,Dakiki Bahar²^ORCID,Goktug Mehmet Refik²,Avcı Okan¹⁸,Tacar Seher Yildiz¹⁸,Turhal Nazım Serdar¹⁹^ORCID,Deniz Gülhan Ipek²⁰,Kacan Turgut¹,Cubukcu Erdem²,Evrensel Türkkan²

Affiliation:

1. Department of Medical Oncology, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa 16350, Turkey

2. Department of Medical Oncology, School of Medicine, Bursa Uludag University, Bursa 16059, Turkey

3. Department of Medical Oncology, Gulhane School of Medicine, University of Health Sciences, Ankara 06018, Turkey

4. Department of Medical Oncology, School of Medicine, Necmettin Erbakan University, Konya 42090, Turkey

5. Department of Medical Oncology, VM Medical Park Samsun Hospital, Samsun 55200, Turkey

6. Department of Medical Oncology, Van Training and Research Hospital, University of Health Sciences, Van 65300, Turkey

7. Department of Medical Oncology, Antalya Training and Research Hospital, University of Health Sciences, Antalya 07100, Turkey

8. Department of Medical Oncology, School of Medicine, Celal Bayar University, Manisa 45140, Turkey

9. Department of Medical Oncology, Medipol University Hospital, Istanbul 34810, Turkey

10. Department of Medical Oncology, Department of Internal Medicine, School of Medicine, Trakya University, Edirne 22130, Turkey

11. Department of Medical Oncology, School of Medicine, Inonu University, Malatya 44280, Turkey

12. Department of Medical Oncology, School of Medicine, Marmara University, Istanbul 34854, Turkey

13. Department of Medical Oncology, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul 34764, Turkey

14. Department of Medical Oncology, Necip Fazıl City Hospital, Kahramanmaraş 46050, Turkey

15. Department of Medical Oncology, Faculty of Medicine, Karabuk University, Karabuk 78100, Turkey

16. Department of Medical Oncology, Afyonkarahisar Health Sciences University, Afyon 03030, Turkey

17. Department of Medical Oncology, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey

18. Department of Medical Oncology, Tekirdağ Namık Kemal University, Tekirdağ 34093, Turkey

19. Department of Medical Oncology, Anadolu Health Center, Kocaeli 2255, Turkey

20. Department of Medical Oncology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul 34371, Turkey

Abstract

Background: This study aimed to investigate the effect of cytoreductive nephrectomy (CN) on the survival outcomes of nivolumab used as a subsequent therapy after the failure of at least one anti-vascular endothelial growth factor (VEGF) agent in patients with metastatic clear-cell renal-cell carcinoma (ccRCC). Methods: We included 106 de novo metastatic ccRCC patients who received nivolumab after progression on at least one anti-VEGF agent. Multivariate Cox regression analysis was performed to investigate the factors affecting survival in patients receiving nivolumab. Results: Of the 106 de novo metastatic ccRCC patients, 83 (78.3%) underwent CN. There were no statistical differences between the two groups in terms of age, gender, Eastern Cooperative Oncology Group (ECOG) score, tumor size, International Metastatic RCC Database Consortium (IMDC) risk group, number of previous treatment lines, first-line anti-VEGF therapy, or metastasis sites (p = 0.137, p = 0.608, p = 0.100, p = 0.376, p = 0.185, p = 0.776, p = 0.350, and p = 0.608, respectively). The patients who received nivolumab with CN had a longer time to treatment discontinuation (TTD) [14.5 months, 95% confidence interval (CI): 8.6–20.3] than did those without CN 6.7 months (95% CI: 3.9–9.5) (p = 0.001). The median overall survival (OS) was 22.7 months (95% CI: 16.1–29.4). The patients with CN had a median OS of 22.9 months (95% CI: 16.3–29.4), while those without CN had a median OS of 8.1 months (95% CI: 5.6–10.5) (p = 0.104). In the multivariate analysis, CN [hazard ratio (HR): 0.521; 95% CI: 0.297–0.916; p = 0.024] and the IMDC risk score (p = 0.011) were statistically significant factors affecting TTD; however, the IMDC risk score (p = 0.006) was the only significant factor for overall survival. Conclusions: Our study showed that the TTD of nivolumab was longer in metastatic ccRCC patients who underwent cytoreductive nephrectomy.

Publisher

MDPI AG

Link

https://www.mdpi.com/1718-7729/31/9/384/pdf

Reference35 articles.

1. Garfield, K., and Lagrange, C.A. (2024, January 01). Renal cell cancer, StatPearls, Available online: https://www.ncbi.nlm.nih.gov/books/NBK470336.

2. Clinicopathological Study of Renal Cell Carcinoma-A Study of 100 Cases;Khan;Ibrahim Card. Med. J.,2018

3. Mancini, M., Righetto, M., and Baggio, G. (2020). Gender-related approach to kidney cancer management: Moving forward. Int. J. Mol. Sci., 21.

4. Cancer statistics, 2023;Siegel;CA A Cancer J. Clin.,2023

5. Current and future systemic treatments for renal cell carcinoma;Fisher;Semin. Cancer Biol.,2013